Background <p>Vascular diseases, such as peripheral arterial occlusive disease (PAOD), abdominal aortic aneurysms (AAA) and carotid stenosis are major causes of morbidity and mortality. Although evidence on gender-specific differences in the diagnostics, treatment and follow-up is increasing, the integration into vascular medicine remains limited.</p> Aim <p>This review aims to highlight gender-specific differences in the epidemiology, clinical course and management of women with PAOD, AAA and carotid stenosis as well as to identify structural and research-related gaps to promote a&#xa0;more individualized approach to vascular medicine.</p> Methods <p>This narrative review is based on frequently cited original articles, review papers and current guidelines relevant to gender-specific aspects in vascular medicine. </p> Results <p>Women patients with PAOD less frequently receive guideline-conform drug treatment, remain underrepresented in structured gait programs and more frequently present with complex femoropopliteal findings or multilevel lesions. In AAA, women experience faster aneurysm growth, have higher rupture rates at smaller diameters and higher perioperative mortality, while the indications for surgery are primarily based on threshold values for men. In the treatment of carotid stenosis women sometimes gain less benefit from surgery for asymptomatic stenosis and face higher periprocedural risks, yet have a&#xa0;similar stroke risk as men when symptomatic. Guideline recommendations are primarily based on data from male-dominated studies.</p> Conclusion <p>The insufficient consideration of gender-specific evidence leads to avoidable disadvantages for female patients. A&#xa0;systematic integration of gender perspectives into research, guidelines and clinical practice is essential to reduce inequalities in treatment and improve outcomes for women.</p>